Postoperative treatment of suprasyndesmotic malleolar fractures
Postoperatively, the joint is held in neutral position by a splint.
If drains are used, they are removed after 24-48 hours. The patient is mobilized with crutches depending on the swelling of the soft tissues.
Postoperative CT control of both ankles is recommended if any syndesmotic incongruence is suspected or if a positioning screw was inserted; special notice is taken of the rotation of the fibula in the syndesmosis, compared with the uninjured side.
Joint motion is allowed and encouraged during physiotherapy. Weight bearing of 20-30 kg when the foot is unsupported. Full weight bearing may be possible using a cast, or an ankle brace, but should not be allowed when a positioning screw is used because of the risk of implant failure.
The positioning screw may be removed after 8-10 weeks.